Fast Facts About Fistula

May 16, 2019

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Never heard of obstetric fistula? If you’re from the United States, that’s not surprising. In the last 20 years, there have been only two cases of obstetric fistula in the United States, but an estimated two million women live with it worldwide. It’s not an obscure disease or a rare virus. A fistula is a hole.

Q: What is obstetric fistula?

A: Obstetric fistula is a serious childbirth-related injury as a result of obstructed, prolonged birth. When a baby’s head is pressed up against the mother’s pelvis for long periods of time during birth, blood supply to the mother’s tissue is cut off and the tissue begins to die. This results in a hole between the vaginal cavity and the bladder or rectum. Typically, the baby is stillborn.

Q: Where does it occur?

A: Obstetric fistula is most common in sub-Saharan Africa, although it is also prevalent in parts of Asia. It has been virtually eliminated in North America and Europe by improving maternal health care.

Q: Who does it affect?

A: Nearly 50 percent all obstetric fistula patients are between the ages of 10 and 19. Child brides, especially those in their early teens, have not entirely gone through the stages of puberty that prepare their bodies for childbirth. Smaller bodies are at higher risk for obstructed births.

However, obstetric fistula can happen to women of any age, but nearly all of them are very poor. Obstetric fistula is most common when an impoverished woman lives too far from a medical facility and does not have access to a skilled birth attendant.

Q: What are the long-term effects?

A: Obstetric fistula is more than a physical wound. Life with an untreated obstetric fistula means a woman has to constantly deal with leaking urine and/or feces. Often, women with fistulas are ostracized by their communities and their families. The pain and smell of a fistula commonly leaves a woman unable to work, meaning she will slip even deeper into poverty. Without treatment, she can never have another baby.

Q: Is it treatable?

A: The good news is that obstetric fistula is almost always treatable through an inexpensive reconstructive surgery. GlobalGiving partner IntraHealth International provides surgeries—at just $70 each—to women living with obstetric fistula in Mali. IntraHealth also trains local surgeons and is working to increase the number of fistula health centers across Mali.

But healing doesn’t end after surgery. In addition to providing surgeries and rehabilitative care, the Kupona Foundation supports recovering fistula patients through socio-economic rehabilitation programs like vocational training, English lessons, and mentorship. By supporting women after surgery, Kupona helps them reintegrate into their communities to lead fulfilling lives. Kupona is also committed to dignified storytelling, earning them an honorable mention in GlobalGiving’s Top 10 Nonprofits Committed to Impact. In 2016, they served more than 1,000 women.

Q: Is it preventable?

A: Obstetric fistula is preventable if a woman has access to good healthcare, including midwives and emergency childbirth services. Obstructed birth can usually be solved through a Caesarian section. Hope Foundation for Women & Children of Bangladesh keeps a database of pregnant women in rural Bangladesh to ensure they have access to antenatal care and are at a hospital during childbirth. Other holistic, preventative measures include postponing marriage, training midwives and birth attendants, and expanding access to hospitals.

Do something to raise awareness of this urgent issue on International Day to End Obstetric Fistula, observed on May 23. Share this article on Twitter!

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